Suchergebnisse

Mary Story, Karen Kaphingst, and Simone French argue that U.S. schools offer many opportunities for developing obesity-prevention strategies by providing more nutritious food, offering greater opportunities for physical activity, and providing obesity-related health services. Meals at school are available both through the U.S. Department of Agriculture's school breakfast and lunch programs and through "competitive foods" sold à la carte in cafeterias, vending machines, and snack bars. School breakfasts and school lunches must meet federal nutrition standards, but competitive foods are exempt from such requirements. And budget pressures force schools to sell the popular but nutritionally poor foods à la carte. Public discomfort with the school food environment is growing. But can schools provide more healthful food options without losing money? Limited evidence shows that they can. Although federal nutrition regulations are inadequate, they permit state and local authorities to impose additional restrictions. And many are doing so. Some states limit sales of nonnutritious foods, and many large school districts restrict competitive foods. Several interventions have changed school food environments, for example, by reducing fat content of food in vending machines and making more fruits and vegetables available. Interventions are just beginning to target the availability of competitive foods. Other pressures can also compromise schools' efforts to encourage physical activity. As states use standardized tests to hold schools and students academically accountable, physical education and recess have become a lower priority. But some states are now mandating and promoting more physical activity in schools. School health services can also help address obesity by providing screening, health information, and referrals to students, especially low-income students, who are at high risk of obesity, tend to be underinsured, and may not receive health services elsewhere.

Two studies examined the persuasive appeal of messages that promote involvement in volunteer work. Four messages were created by combining two different strategies of argument (one providing reasons for volunteering, the other countering reasons for not volunteering) and two different forms of reasons for volunteering or not volunteering (abstract, value-based reasons versus concrete, specific reasons). In both studies, college students with and without current volunteer experience judged the counter-abstract-reasons-for-not-volunteering and provide-concrete-reasons-for-volunteering messages to be the most persuasive. However, the effectiveness of a message also depended on the goal of the appeal (that is, recruitment of new volunteers or retention of current volunteers). The implications of these findings for campaigns designed to promote volunteerism are discussed.

Purpose. This pilot study examined nutrition-related attitudes that may affect food choices at fast-food restaurants, including consumer attitudes toward nutrition labeling of fast foods and elimination of value size pricing. Methods. A convenience sample of 79 fast-food restaurant patrons aged 16 and above (78.5% white, 55% female, mean age 41.2 [17.1]) selected meals from fast-food restaurant menus that varied as to whether nutrition information was provided and value pricing included and completed a survey and interview on nutrition-related attitudes. Results. Only 57.9% of participants rated nutrition as important when buying fast food. Almost two thirds (62%) supported a law requiring nutrition labeling on restaurant menus. One third (34%) supported a law requiring restaurants to offer lower prices on smaller instead of bigger-sized portions. Conclusion. This convenience sample of fast-food patrons supported nutrition labels on menus. More research is needed with larger samples on whether point-of-purchase nutrition labeling at fast-food restaurants raises perceived importance of nutrition when eating out.

Purpose. To examine the effect of lifestyle on the effectiveness of a low-intensity dietary intervention. Design. A secondary data analysis was performed using data from the Eating Patterns Study, a randomized controlled trial that found that self-help materials with physician advice was effective in changing dietary intake and behavior. Setting. Primary care clinics in a large health maintenance organization. Subjects. A total of 2111 patients with a routine scheduled appointment with their primary care physicians. Measures. Participants were grouped into one of six health lifestyle patterns based on similarities in baseline measures of alcohol intake, smoking, diet quality, and exercise. Within each lifestyle pattern, changes from baseline in usual fat and fiber intake (based on a food frequency) and a fat and fiber behavior score were compared at 3 months and 12 months for intervention vs. control participants. Intervention. Self-help materials delivered by a physician with advice to change diet. Results. Intervention participants in the fitness lifestyle group made the largest changes relative to controls for each dietary outcome at 3 and 12 months. For intervention participants defined by their alcohol intake or current smoking, either no changes in diet were observed compared with controls, or early changes were not sustained over time. Intervention-control comparisons within the remaining lifestyle patterns showed smaller dietary changes compared with the fitness lifestyle. This finding was similar to previously published results. Conclusions. This randomized controlled trial had limited power to detect subgroup differences; however, these results suggest that lifestyle patterns may be useful in the development of effective, targeted interventions to change behavior.

Purpose. The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. Design. Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. Setting. The study was conducted at a university and three local health department sites. Subjects. Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain.1 Measures. The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. Results. Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offerings ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offerings attracted health-conscious participants with higher education and income levels. Conclusions. These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.

Purpose. To gather consumer input about approaches to providing energy composition information for foods on fast-food restaurant menus. Design. We asked a subset of individuals (n = 150) in an experimental study about the influence of nutrition labeling on fast-food meal choices to evaluate calorie information on mock fast-food menus in various formats. Setting. Three community sites in the Minneapolis-St. Paul, Minnesota, metropolitan area. Subjects. Adolescents and adults who ate fast food at least once per week were recruited. Measures. Via a series of open- and close-ended questions, participants gave feedback about several formats for providing energy composition information for foods on fast-food restaurant menus. Analysis. Means and frequencies were calculated, and χ2 tests were conducted. Results. When asked to compare a menu that provided calorie information for each menu item with a menu that provided the number of minutes of running that would be required to burn the calories contained in each menu item, 71.0% of participants preferred the calorie information over the physical activity information. Participants also compared two approaches to providing caloric reference information on the menu (average daily calorie needs per day vs. per meal), and 61.3% preferred the calorie needs—per-meal format. Conclusion. Our results may be useful in designing approaches to providing energy composition information for foods on fast-food restaurant menus.